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Diabet Med ; 26(12): 1296-300, 2009 Dec.
Article in English | MEDLINE | ID: mdl-20002485

ABSTRACT

AIMS: Individuals with diabetic retinopathy (DR) represent a high-risk group who would benefit from intensive metabolic control and risk factor management. This brief report examines quality of care among diabetic patients attending a tertiary retinal clinic. METHODS: A cross-sectional survey, notes review, and slit-lamp examination was conducted in 139 diabetic patients attending a specialist retinal clinic to assess the quality of comprehensive diabetes care. DR was graded according to the Early Treatment Diabetic Retinopathy Study scale. RESULTS: The prevalence of non-proliferative DR (NPDR) and proliferative DR (PDR) was 39.6 and 35.2%, respectively. The prevalence of microalbuminuria in patients with no DR, NPDR and PDR was 32, 54.1 and 68.8%, respectively. Glycaemic control was suboptimal (mean HbA(1c) 8.0 +/- 1.8%) and 15.8% were current smokers. Drugs affecting the renin-angiotensin system were used by only 61.9% of patients with both DR and microalbuminuria, and aspirin by only 35.3%. CONCLUSIONS: These data suggest that diabetes care in this high-risk population with established microvascular complications was suboptimal. Specialist clinics dealing with diabetic complications may be a setting where quality improvement strategies to reduce morbidity and mortality should be focused.


Subject(s)
Delivery of Health Care/standards , Diabetes Mellitus, Type 1/therapy , Diabetes Mellitus, Type 2/therapy , Diabetic Retinopathy/epidemiology , Adult , Aged , Albuminuria/epidemiology , Cross-Sectional Studies , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/complications , Diabetic Retinopathy/diagnosis , Female , Glycated Hemoglobin/analysis , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Prevalence
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